Green Room

The Public Option – Individual Mandate Two-step

posted at 9:02 am on August 17, 2009 by

Michelle Malkin thinks that the Obama administration’s softening on its proposed government-run health insurance plan is more a trial balloon than a white flag. Indeed, this weekend’s statements were not all that newsworthy. As Marc Ambinder correctly notes, Rahm Emanuel has known for months that even a neutered public plan with a trigger mechanism did not have the votes to pass. The administration will likely be forced to sneak in public insurance under the rubric of co-ops.

However, the latest “trial balloon” here was likely an unintentional blunder. The public opinion polling on ObamaCare — particularly its more high-profile elements — now generally takes the form of “Democrats support it, but not Republicans or unaffiliated voters.” Many on the Left equate healthcare reform with the “public option” trojan horse (and are suspicious of the co-op trojan horse), so to ditch it now would cause support for their campaign to crater. The Democrats simply cannot afford to abandon the government-run plan so soon.

The other big reason the Democrats cannot ditch the “public option” yet is precisely because it would allow ObamaCare critics to concentrate their fire on other key elements of their plan. That includes the co-op idea, though it should be fairly easy to discredit as the “public option in sheep’s clothing.” In the medium-term, it may be more significant that the “public option” helps the Democrats deflect fire from the individual mandate.

Killing the public plan is essential, but not enough to prevent government-run health care. Ramesh Ponnuru makes the case for focusing on the individual mandate:

First, the basic outline of Obamacare can survive ditching the public option. It can’t survive ditching the individual mandate. You can’t, for example, have a ban on insurers’ taking account of pre-existing conditions without such a mandate.

Second, the polling on an individual mandate suggests that it’s less popular than the public option — and just plain unpopular. I keep pointing out that Obama was able to win the Democratic presidential primaries without embracing a mandate, which ought to tell us something about the politics of the issue.

Third, my impression from talking to Republican congressmen about the issue is that to the extent they support this idea, that support is an inch deep. It rests on misunderstandings that are easy to clear up (notably the notion that a mandate would reduce insurance premiums by making the uninsured pay their fair share).

Fourth, we have already made our case on the public option, and we haven’t made it on the mandate.

Fifth, there are interest groups willing to keep making the case on the public option — but most of these interest groups are for the mandate since it would improve their bottom lines (at least in the short term).

Ponnuru is not entirely correct on all of those points. The Right needs to keep the heat on the “public option” — as toppling it would greatly demoralize the Democrats — but the Right also needs to start attacking the individual mandate. Though you can find polls like Quinnipiac that show opposition, you can find recent polls (e.g., Gallup and Pew) supporting the individual mandate. However, as with the politicians, that support is about an inch deep. The individual mandate gets very bad numbers if people are told there will be fines for those who do not buy insurance (EBRI and NBC/WSJ) or that some could be required to buy insurance they cannot afford or do not want (KFF). And there is a real-world example of these problems with the individual mandate:

Massachusetts has a mandate right now. They have exempted 20 percent of the uninsured because they have concluded that that 20 percent can’t afford it.

In some cases, there are people who are paying fines and still can’t afford it, so now they’re worse off than they were. They don’t have health insurance and they’re paying a fine.

That was candidate Barack Obama’s opinion. The Right needs to remind the public of this early and often.

Recently in the Green Room:

Blowback

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Michelle got it right. It’s a Leninist ploy, ‘Obama on Public Option: Two Steps Forward One Step Back’.

Donald Douglas on August 17, 2009 at 9:14 AM

The current travesty Obama calls a Public Option is not dead. Dem leaders are moving the PO off-line. It will not be in the House version, there’s too many free thinkers in the House, so BO and his Chicago mob are moving it to the Senate, where there are fewer moderates to intimidate. Rahm will promise them that millions will be spent against any D Senator who dares stand against it.

RE (stabbing steak knife into table): “Any f—ing Senator who f—ing stands in our f—cking way? F—ing dead! Dead!!

Insurance regulation, drug cost control, tort reform, putting more GP’s into the field. All needed, all ignored.

MarkT on August 17, 2009 at 9:24 AM

Posting this again, feel free to comment on the Flickr page.

Obama Flip-Flops

BKeyser on August 17, 2009 at 1:51 PM

Sorry, the link didn’t work. Trying again:

Obama Flip-Flops

BKeyser on August 17, 2009 at 1:53 PM

The simple fact is that a strong majority of Americans don’t want Obamacare. The bloom is off the silver-tongued-Obama rose. It’s going to be hard for them to work around that. If they do, they’ll pay in the 2010 election. Think of the start-up problems (e.g. the recent Cash for Clunkers fiasco which is a drop in the bucket in comparison).

It’s okay to be optimistic but not to be complacent.

Drained Brain on August 17, 2009 at 1:55 PM

a mandate would reduce insurance premiums by making the uninsured pay their fair share).

. . . and that gives the game away.

Why do I have to carry auto insurance? Because if I operate my automobile in a reckless and negligent manner, texting, talking on the cell phone, reading a book while driving, and cause a collusion with another vehicle, other people get hurt.

If I do not have health insurance and suffer some calamity and am unable to pay for health care, I am the party who suffers. Unless you want to attempt the argument that friends and family would suffer from my passing. (As if.)

Changing the argument to ‘paying your fair share’ by government fiat, the mandatory participation in health ‘insurance’ changes it from voluntary sharing of costs, into a government tax that punishes responsible behavior, and rewards undesired behavior.

Skandia Recluse on August 17, 2009 at 1:58 PM

But wait…………I thought we could trust The Messiah – I mean he crowned himself both here and in Germany in Temple-like settings…………you mean he is someone we cannot trust? Taxes? Foreign Policy? America’s exceptionalism? The Dept. of Justice. Backroom deals with BigPharma? Illegals including his Auntie? His wife’s BIG mouth and $10,000 purses? Well I KNOW we can at least trust that he was born in the good old US of A……………can’t we?

Cinday Blackburn on August 17, 2009 at 2:06 PM

And yes the individual mandate amounts to a government restriction on my freedom of choice. Period.

sonnyspats1 on August 17, 2009 at 2:08 PM

Can you imagine the scheming Pelosi and Reid are doing? OMG, they could teach a course on the art of lying.

marklmail on August 17, 2009 at 2:21 PM

Heh, fun looking at the fantasy of “killing the public option”.

As posted elsewhere, here is the reality:

-House Ways & Means – PASSED – “Strong” public option
-House Education & Labor – PASSED – Public option
-House Energy & Commerce – PASSED – Public option
-The reconciled final House “Tri-Committee” Bill passed with a strong public option.

-Senate HELP Committee – PASSED – Public option
-Senate Finance Committee – Where all of the hoopla is…

So, the Public Option is dead? Not by a long shot.

Basically Obama just needs to get whatever is going on in the Finance Committee out and then work things back with conferences.

The straight up/down vote is the only thing left in the House.

ckoeber on August 17, 2009 at 2:22 PM

The mandate, as is currently written, doesn’t just affect the uninsured. My family of 3 has an insurance policy that hubby and I purchased on our own (ie, not through an employer). It is a high-deductible plan, meant to be used primarily for catastrophic illness or accidents, that does not meet the definition of a “qualified” plan under the current House or Senate drafts.

In the section that details out the mandate and the tax penalty associated with it, it states that if you don’t have a plan that is deemed “qualified” under the section that lays out said qualifications, you pay the tax.

In a nutshell, my family is young, healthy, and we have been responsible with our health and our money so that we could purchase what only what we NEED in health coverage and pay for routine services out of pocket. But we will be taxed anyway under this mandate because our plan doesn’t meet the “qualifications”.

This is the point we have to really hammer home. Even if you have insurance, if the government decides your plan isn’t good enough, you are penalized.

mrflibbleisvryx on August 17, 2009 at 2:31 PM

Republicans should not celebrate too soon. Nationalized health care and mandatory health insurance may be failing, but the failed past entitlements are still on life support. About the only good thing one could say about ObamaCare is that Congress tried to figure out some way to deal with the Medicare mess, and we will still need to do that at some point in the relatively near future.

MTF on August 17, 2009 at 2:43 PM

Which brings us back to you can’t trust one bit of this passing. If they get 1/2 or 2/3 of this crap sandwich to pass, it is just a matter of time before they start tweaking it and adding new components into the highway bill.
We have to let them know that any bill will cost them their job!

Dog bites on August 17, 2009 at 5:48 PM